ABR NMP case studies
ABR NMP · Put your knowledge to work in context.
The ABR Nuclear Medical Physics Part 2 Qualifying Exam is the specialty-specific second step toward ABR certification in medical physics. It is aimed at candidates who have already passed Part 1 (both the General and Clinical sections) and who have completed, or are on track to complete, a CAMPEP-accredited residency or DMP program by August 31 of the exam year. The ABR NMP case studies are 5 cases and about 3,000 words.
1The 90Y microsphere dose that disagrees with the treatment plan
A 67-year-old man with unresectable hepatocellular carcinoma (single 6.2 cm lesion, Child-Pugh A) is treated with resin 90Y microspheres via lobar infusion. The dosimetry team used a partition model on a pre-treatment 99mTc-MAA SPECT/CT and predicted a tumor absorbed dose of 142 Gy and a normal-liver dose of 28 Gy.
691 words, about 3 min2The sentinel-node injection that exceeds the ALARA plan
A nuclear medicine technologist is preparing a 99mTc-sulfur colloid lymphoscintigraphy study for a 48-year-old woman with newly diagnosed breast cancer. The surgeon has asked for a four-quadrant periareolar injection of 0.5 mCi (18.5 MBq) total, given as four 0.125 mCi aliquots, 2 hours before surgery.
593 words, about 3 min3The PET/CT incidental finding and the question of who tells the patient
A 58-year-old woman undergoes an 18F-FDG PET/CT for staging of a newly diagnosed lung adenocarcinoma. The study is ordered by her medical oncologist.
583 words, about 3 min4The recalibration that would bring the dose rate within the license limit
A community hospital operates a 131I therapy program under a written directive. The licensee's license authorizes release of patients under 10 CFR 35.75 using the dose-rate criterion of 7 mrem/h (0.07 mSv/h) at 1 meter.
618 words, about 3 min5The resident's research project that reuses clinical images
A second-year nuclear medicine resident wants to present a retrospective study at a national meeting on the diagnostic performance of 18F-FDG PET/CT for detecting mediastinal nodal involvement in lung cancer. She plans to pull 220 studies from the department's PACS from the past 3 years, record SUVmax values, and correlate them with pathology from the electronic medical record.
515 words, about 3 min